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Diet and Physical Activity in Childhood Cancer Survivors: A Review of the Literature

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Treatment advances have led to a growing population of childhood cancer survivors. Many are at risk for developing treatment-related late effects. Diet and physical activity may affect levels of health risk. A number of papers have examined these behaviors in childhood cancer survivors. The purpose of this study was to provide a review and summary of the published studies in the areas of diet, physical activity, and related interventions among childhood cancer survivors. A systematic search was conducted for studies published prior to October 2009. Descriptive and intervention studies that included survivors of childhood cancers and a measurement of diet and/or physical activity were reviewed. Twenty-six manuscripts met criteria: ten addressed diet; 20 addressed physical activity, and six included intervention studies. Results suggest that childhood cancer survivors engage in health-promoting activities at rates comparable to the general population. Behavioral interventions have mostly targeted physical activity. Results, overall, are not encouraging, due primarily to difficulties recruiting and retaining participants. Although more rigorous studies are needed, recommendations for health-promoting behaviors should be a regular topic of discussion between health care providers and their childhood cancer survivor patients.

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References

  1. American Cancer Society. Cancer facts & figures 2008. Atlanta: American Cancer Society; 2008.

    Google Scholar 

  2. National Cancer Institute. Surveillance, Epidemiology and End Results (SEER) Program, source for cancer statistics in the United States. Available at http://www.seer.cancer.gov/. Accessibility verifier October 15, 2009.

  3. American Cancer Society. Cancer facts and figures 2003. Atlanta: American Cancer Society; 2003. Report No: 5008.03.

    Google Scholar 

  4. Mariotto AB, Rowland JH, Yabroff KR, et al. Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomark Prev. 2009;18:1033–1040.

    Article  Google Scholar 

  5. Bleyer WA. The us pediatric cancer clinical trials programs: International implications and the way forward. Eur J Cancer. 1997;33:1439–1447.

    Article  CAS  PubMed  Google Scholar 

  6. Meadows AT, Gallagher JA, Bunin GR. Late effects of early childhood cancer therapy. Br J Cancer. 1992;18:S92–95.

    CAS  Google Scholar 

  7. Green DM. Long term complications of treatment for cancer during childhood and adolescence. Baltimore: Johns Hopkins University Press; 1989:1–165.

    Google Scholar 

  8. DeLaat CA, Lampkin BC. Long-term survivors of childhood cancer: Evaluation and identification of sequelae of treatment. CA Cancer J Clin. 1992;42:263–282.

    Article  CAS  PubMed  Google Scholar 

  9. Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355:1572–1582.

    Article  CAS  PubMed  Google Scholar 

  10. Hoffman KE, Derdak J, Bernstein D, et al. Metabolic syndrome traits in long-term survivors of pediatric sarcoma. Pediatr Blood Cancer. 2008;50:341–346.

    Article  PubMed  Google Scholar 

  11. Atkinson SA. Vitamin d status and bone biomarkers in childhood cancer. Pediatr Blood Cancer. 2008;50:479–482.

    Article  PubMed  Google Scholar 

  12. Oeffinger KC, Nathan PC, Kremer LCM. Challenges after curative treatment for childhood cancer and long-term follow up of survivors. Pediatr Clin N Am. 2008;55:251–273.

    Article  Google Scholar 

  13. Oeffinger KC. Are survivors of acute lymphoblastic leukemia (all) at increased risk of cardiovascular disease? Pediatr Blood Cancer. 2008;50:462–467.

    Article  PubMed  Google Scholar 

  14. Florin TA, Fryer GE, Miyoshi T, et al. Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: A report from the childhood cancer survivor study. Cancer Epidemiol Biomark Prev. 2007;16:1356–1363.

    Article  Google Scholar 

  15. van der Sluis IM, van den Heuvel-Eibrink MM. Osteoporosis in children with cancer. Pediatr Blood Cancer. 2008;50:474–478.

    Article  PubMed  Google Scholar 

  16. Tillmann V, Darlington ASE, Eiser C, Bishop NJ, Davies HA. Male sex and low physical activity are associated with reduced spine bone mineral density in survivors of childhood acute lymphoblastic leukemia. J Bone Miner Res. 2002;17:1073–1080.

    Article  CAS  PubMed  Google Scholar 

  17. Clarke S-A, Eiser C. Health behaviours in childhood cancer survivors: A systematic review. Eur J Cancer. 2007;43:1373-1384.

    Article  PubMed  Google Scholar 

  18. Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: Promoting long-term health after the diagnosis of cancer. J Clin Oncol: J Am Soc Clini Oncol. 2005;23:5814–5830.

    Google Scholar 

  19. Winter C, Müller C, Hoffmann C, Boos J, Rosenbaum D. Physical activity and childhood cancer. Pediatric Blood and Cancer [online ahead of print]. 2009; Available from: http://www3.interscience.wiley.com/journal/122593119/abstract] Accessed October 15, 2009.

  20. Nathan PC, Ford JS, Henderson TO, et al. Health behaviors, medical care, and interventions to promote healthy living in the childhood cancer survivor study cohort. J Clin Oncol: J Am Soc Clin Oncol. 2009;27:2363–2373.

    Google Scholar 

  21. Castellino SM, Casillas J, Hudson MM, et al. Minority adult survivors of childhood cancer: A comparison of long-term outcomes, health care utilization, and health-related behaviors from the childhood cancer survivor study. J Clin Oncol: J Am Soc Clin Oncol. 2005;23:6499–6507.

    Google Scholar 

  22. Ness KK, Wendy ML, Sujuan H, et al. Predictors of inactive lifestyle among adult survivors of childhood cancer. Cancer. 2009;115:1984–1994.

    Article  PubMed  Google Scholar 

  23. Elkin T, David TVL, Hudson M, Crom D. Participation in sports by long-term survivors of childhood cancer. J Psychosoc Oncol. 1998;16:63–73.

    Article  Google Scholar 

  24. Demark-Wahnefried W, Werner C, Clipp EC, et al. Survivors of childhood cancer and their guardians. Cancer. 2005;103:2171–2180.

    Article  PubMed  Google Scholar 

  25. Robien KPRD, Ness KKPTP, Klesges LMP, Baker KSMDMS, Gurney JGP. Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol/Oncol. 2008;30:815–822.

    Article  Google Scholar 

  26. Reeves M, Eakin E, Lawler S, Demark-Wahnefried W. Health behaviours in survivors of childhood cancer. Aust Fam Physician. 2007;36:95–96.

    PubMed  Google Scholar 

  27. Keats MR, Culos-Reed SN, Courneya KS, McBride M. An examination of physical activity behaviors in a sample of adolescent cancer survivors. J Pediatr Oncol Nurs. 2006;23:135–142.

    Article  PubMed  Google Scholar 

  28. Mayer EIE, Reuter M, Dopfer RE, Ranke MB. Energy expenditure, energy intake and prevalence of obesity after therapy for acute lymphoblastic leukemia during childhood. Horm Res. 2000;53:193–199.

    Article  CAS  PubMed  Google Scholar 

  29. Takken T, van der Torre P, Zwerink M, et al. Development, feasibility and efficacy of a community-based exercise training program in pediatric cancer survivors. Psycho-Oncol. 2009;18:440–448.

    Article  Google Scholar 

  30. Blaauwbroek R, Bouma M, Tuinier W, et al. The effect of exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer: A pilot study. Support Care Cancer. 2009;17:1041–1048.

    Article  Google Scholar 

  31. Keats MR, Courneya KS, Danielsen S, Whitsett SF. Leisure-time physical activity and psychosocial well-being in adolescents after cancer diagnosis. J Pediatr Oncol Nurs. 1999;16:180–188.

    CAS  PubMed  Google Scholar 

  32. Keats MR, Culos-Reed SNP. A community-based physical activity program for adolescents with cancer (project trek): Program feasibility and preliminary findings. J Pediatr Hematol/Oncol. 2008;30:272–280.

    Article  Google Scholar 

  33. Finnegan L, Wilkie DJ, Wilbur JE, Campbell RT, Zong S, Katula S. Correlates of physical activity in young adult survivors of childhood cancers. Oncol Nurs Forum. 2007;34:E60–69.

    Article  PubMed  Google Scholar 

  34. Cox CL, McLaughlin RA, Rai SN, Steen BD, Hudson MM. Adolescent survivors: A secondary analysis of a clinical trial targeting behavior change. Pediatr Blood Cancer. 2005;45:144–154.

    Article  PubMed  Google Scholar 

  35. Collett B, Acosta A, Whitsett S, McTiernan A, Friedman D. Exercise intervention for pediatric cancer survivors: Feasibility and preliminary efficacy. J Clin Oncol. 2007;25:20013 (Meeting Abstracts).

    Google Scholar 

  36. Evans SE, Radford M. Current lifestyle of young adults treated for cancer in childhood. Arch Dis Child. 1995;72:423.

    Article  CAS  PubMed  Google Scholar 

  37. Hudson MM, Tyc VL, Srivastava DK, et al. Multi-component behavioral intervention to promote health protective behaviors in childhood cancer survivors: The protect study. Med Pediatr Oncol. 2002;39:2–1. discussion 2.

    Article  PubMed  Google Scholar 

  38. Mulhern RK, Tyc VL, Phipps S, et al. Health-related behaviors of survivors of childhood cancer. Med Pediatr Oncol. 1995;25:159–165.

    Article  CAS  PubMed  Google Scholar 

  39. Oeffinger KC, Buchanan GR, Eshelman DA, et al. Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol/Oncol: J Am Soc Pediatr Hematol/Oncol. 2001;23:424–430.

    Article  CAS  Google Scholar 

  40. Tyc VL, Hadley W, Crockett G. Prediction of health behaviors in pediatric cancer survivors. Med Pediatr Oncol. 2001;37:42–46.

    Article  CAS  PubMed  Google Scholar 

  41. Tercyak KP, Donze JR, Prahlad S, Mosher RB, Shad AT. Multiple behavioral risk factors among adolescent survivors of childhood cancer in the survivor health and resilience education (share) program. Pediatr Blood Cancer. 2006;47:825–830.

    Article  PubMed  Google Scholar 

  42. Sharkey AM, Carey AB, Heise CT, Barber G. Cardiac rehabilitation after cancer therapy in children and young adults. Am J Cardiol. 1993;71:1488–1490.

    Article  CAS  PubMed  Google Scholar 

  43. Butterfield RM, Elyse RP, Puleo E, et al. Multiple risk behaviors among smokers in the childhood cancer survivors study cohort. Psycho-Oncol. 2004;13:619–629.

    Article  Google Scholar 

  44. Cox CL, Montgomery M, Oeffinger KC, et al. Promoting physical activity in childhood cancer survivors. Cancer. 2009;115:642–654.

    Article  PubMed  Google Scholar 

  45. Robison LL, Mertens AC, Boice JD, et al. Study design and cohort characteristics of the childhood cancer survivor study: A multi-institutional collaborative project. Med Pediatr Oncol. 2002;38:229–239.

    Article  PubMed  Google Scholar 

  46. Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998;280:1371–1374.

    Article  CAS  PubMed  Google Scholar 

  47. NIH/NHLBI. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report; 1998.

  48. Brownell KD. The environment and obesity. In: Fairburn CG, Brownell KD, eds. Eating disorders and obesity. New York: Guilford Press; 2002:433–438.

    Google Scholar 

  49. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition and physical activity, and the prevention of cancer: A global perspective. Washington: AICR; 2007.

    Google Scholar 

  50. U.S. Department of Health and Human Services (HHS). 2008 Physical activity guidelines for Americans. HHS, Washington; 2008

  51. Rogers CJ, Colbert LH, Greiner JW, Perkins SN, Hursting SD. Physical activity and cancer prevention: Pathways and targets for intervention. Sports Med. 2008;38:271–296.

    Article  PubMed  Google Scholar 

  52. US Centers for Disease Control and Prevention. Behavioral risk factor surveillance system user's guide 1998; Available from: http://www.cdc.gov/nccdphp/dnpa/physical/recommendations/index.htm. Accessibility verified Jan 27, 2005.

  53. US Department of Health and Human Services. Physical activity and health: A report of the surgeon general. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion: Atlanta; 1996.

  54. US Department of Health and Human Services. Surgeon general’s call to action to prevent and decrease overweight and obesity. Office of Disease Prevention and Health Promotion; Centers for Disease Control and Prevention, National Institutes of Health. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Office of the Surgeon General: Washington, D.C.; 2001.

  55. Courneya KS. Exercise in cancer survivors: An overview of research. Med Sci Sports Exerc. 2003;35:1846–1852.

    Article  PubMed  Google Scholar 

  56. Chlebowski RT, Blackburn GL, Thomson CA, et al. Dietary fat reduction and breast cancer outcome: Interim efficacy results from the women's intervention nutrition study. J Natl Cancer Inst. 2006;98:1767–1776.

    Article  PubMed  Google Scholar 

  57. Pierce JP, Stefanick ML, Flatt SW, et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007;25:2345–2351.

    Article  PubMed  Google Scholar 

  58. Ressler IB, Cash J, McNeill D, Joy S, Rosoff PM. Continued parental attendance at a clinic for adult survivors of childhood cancer. J Pediatr Hematol/Oncol. 2003;25:868–873.

    Article  Google Scholar 

  59. Arroyave W, Clipp E, Miller P, et al. Childhood cancer survivors' perceived barriers to improving exercise and dietary behaviors. Oncol Nurs Forum. 2008;35:121–130.

    Article  PubMed  Google Scholar 

  60. Doyle C, Kushi LH, Byers T, et al. Nutrition and physical activity during and after cancer treatment: An American Cancer Society guide for informed choices. CA Cancer J Clin. 2006;56:323–353.

    Article  PubMed  Google Scholar 

  61. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition and physical activity, and the prevention of cancer: A global perspective. AICR: Washington, D.C., 2007.

  62. U.S. Department of Health and Human Services. Healthy people 2010. Washington, D.C.; 2000.

  63. National Cancer Institute (NCI). Facing forward series: Life after cancer treatment. 2002. Report No: 02-2424.

  64. Institute of Medicine, National Research Council. From cancer patient to cancer survivor. Washington D.C.; 2006.

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Authors and Affiliations

  1. Section of Health Promotion Research, Department of Medicine, University of Illinois, Chicago, IL, USA

    Melinda R. Stolley Ph.D., Jacqueline Restrepo BS & Lisa K. Sharp Ph.D.

  2. Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA

    Melinda R. Stolley Ph.D.

  3. University of Illinois Chicago, 1747 Roosevelt Avenue, M/C 275, Chicago, IL, 60608, USA

    Melinda R. Stolley Ph.D.

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  1. Melinda R. Stolley Ph.D.
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  2. Jacqueline Restrepo BS
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  3. Lisa K. Sharp Ph.D.
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Correspondence to Melinda R. Stolley Ph.D..

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Stolley, M.R., Restrepo, J. & Sharp, L.K. Diet and Physical Activity in Childhood Cancer Survivors: A Review of the Literature. ann. behav. med. 39, 232–249 (2010). https://doi.org/10.1007/s12160-010-9192-6

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